Depression

Depression is a relatively common mental health condition associated with low moods and a negative outlook on life. Sufferers may also feel socially disconnected and unable to enjoy activities that they previously found satisfying. While heavy cannabis use has been found to increase such symptoms, THC is also associated with the improvement of mood.

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Condition overview

It is very common for people to feel depressed after difficult personal events such as the breakdown of a relationship or the death of a loved one. However, a clinical diagnosis of depression is made when low mood is experienced over a lengthy period of time and interferes with everyday life. Depression may vary in severity, and can lead to a wide variety of emotional and physical problems, ranging from a loss of interest to persistent thoughts of suicide.

Common symptoms

A diagnosis for depression may be made when an individual has been suffering from some of these symptoms most of the day, nearly every day, for at least two weeks:

Persistent feelings of sadness or “emptiness”
Decreased interest in previously enjoyed hobbies and activities
Changes in appetite and/or weight
Irritability
Sleep loss
Anxiety

Common causes

There are various types of depression, including Seasonal Affective Disorder (commonly caused by the worsening of the weather), Dysthymia (a mild form of depression lasting for two years or more), Prenatal Depression (depression that occurs during pregnancy), and Postnatal Depression (depression in the first year after childbirth). Each of these forms of depression is associated with an imbalance of chemicals within the brain; in particular, low levels of serotonin and dopamine.

Other causes of depression:

Impactful life events such as bereavement, job loss, or serious illness
Genetics (those with a family history are more likely to experience depression themselves)
Hormonal changes
A lack of support and/or abuse after LGBTQ disclosure
Abuse of alcohol or recreational drugs

Standard treatment

Treatment should be prescribed based on the severity of the depression, with some patients being advised to wait and see if the symptoms reduce naturally with lifestyle changes alone. Regular assessments are required in such instances.

In individuals suffering from moderate to severe depression, a combination of antidepressant medication and psychotherapy (CBT in particular) is typically recommended. Commonly prescribed medications include SSRIs, SNRIs, tricyclic antidepressants and MAO inhibitors. Anxiolytics and antipsychotics may also be prescribed for short-term use.

How medical cannabis could help

Medical cannabis has the potential to exert antidepressant effects via modulation of the endocannabinoid system and interaction with serotonin receptors. Several studies have shown that medical cannabis can improve mood in patients suffering with chronic pain, and this can also be accompanied by a reduction in the intake of antidepressant medications such as SSRIs and SNRIs.

Direct evidence supporting medical cannabis use in patients with a primary diagnosis of depression is, however, broadly lacking at present.

Nevertheless, there is emerging observational evidence that high-CBD preparations could help patients suffering with anxiety and/or depression. Introducing THC should be done so gradually in this patient group (unless the patient reports prior success) given its potential to exert anxiogenic effects at higher doses

FAQs about Medical Cannabis

Is medical cannabis legal in the UK?

Yes. Cannabis-based medicinal products (CBMPs) have been legal since the 1st of November 2018, when they moved from a Schedule 1 product to a Schedule 2 product. This reflects their potential for medical use.

Who is allowed to prescribe medical cannabis in the UK?

Cannabis-based medicinal products, also known as CBMPs, can be prescribed by private consultants, when appropriate, within their specialty area when there is unmet clinical need.

In the UK cannabis medicines are accessed primarily via private clinics. However, any specialist physician can prescribe cannabis medicines. GROW® is here to provide education and support to any specialists looking to prescribe or just to find out more.

Is medical cannabis available on the NHS?

There are 3 licensed medicines which contain cannabinoids – Epidiolex for some forms of epilepsy, Sativex for multiple sclerosis (MS), and Nabilone for chemotherapy-induced nausea and vomiting (CINV). However, only a handful of prescriptions have been issued in the NHS to date.

Most cannabis-based medicinal products (CBMPs) are instead unlicensed, and they must be written on a private prescription, typically issued by private clinics specialising in medical cannabis treatment.

What cannabis medicines are available?

Cannabis medicines come in multiple forms; flowers, often referred to as herbal cannabis (to be vaporised, rather than smoked), oils (taken under the tongue) and capsules. Cannabis medicines come in high-THC, high-CBD and balanced varieties.

Smoking medical cannabis is illegal. Medical cannabis can instead be taken in different forms depending on the desired speed of onset and duration of action, which is discussed between the patient and their doctor.

Which clinic should I use?

It’s important to find a clinic that works for you. Most importantly you need to find a Doctor that specialises in your condition. For example, patients with pain will need to see pain specialist, while those with a mental health condition must see a psychiatrist.

Which pharmacies can I use?

It’s important for patients to know they can use any pharmacy that supplies the appropriate medicines in the UK.

Some clinics have a preferred pharmacy but will be able to send prescriptions to others if needed. If patients have any questions about available medicines, they can contact IPS Pharma.

What should I do before my consultation?

To speed up the process, patients should bring a copy of their medical records. These are then forwarded to the clinic in advance of the first consultation.

Is medical cannabis the same as over-the-counter CBD?

No. Cannabis-based medicinal products (CBMPs) are only prescribed by GMC-registered specialist doctors. As they are medicinal, CBMPs are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA); which ensures the safety, quality, and effectiveness of medicines in the UK.

Over-the-counter (OTC) CBD products can be purchased without a prescription in pharmacies, health food shops, or online. These may come in forms such as oil tinctures, capsules, or vapes. They are not medicinal products as they are regulated by the Food Standards Agency (FSA) as a food supplement, with a 0.3% limit on THC.

What if I don’t get a prescription?

Patients are free to seek a second opinion from another clinic. Patients should ensure the clinic has communicated their reasons for deciding not to prescribe. It may be that they feel you should try other medicines before trying cannabis medicines, or that they need to see more information about your medical history before they are happy to prescribe.

How can I learn more about medical cannabis?

For patient enquiries - [email protected]

For doctor enquiries - [email protected]

For all other enquiries – [email protected]

Healthcare professionals can also sign up to our Doctor Portal.

Depression

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FAQs about Medical Cannabis

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